本文關(guān)鍵詞：溫腎暖脾通下方對嚴(yán)重膿毒癥患者免疫麻痹的影響　出處：《中國中醫(yī)藥科技》2017年02期 　論文類型：期刊論文

  更多相關(guān)文章： 嚴(yán)重膿毒癥 免疫麻痹 降鈣素原 溫腎暖脾通下方 溫脾湯

【摘要】：目的:觀察溫腎暖脾通下方治療嚴(yán)重膿毒癥患者的臨床療效及其對免疫麻痹的調(diào)節(jié)作用。方法:60例嚴(yán)重膿毒癥患者隨機分為2組,每組30例,對照組采用西醫(yī)常規(guī)治療,觀察組在對照組治療基礎(chǔ)上輔以溫腎暖脾通下方治療。觀察2組治療前及治療第5 d、第10 d APACHEII評分、免疫學(xué)相關(guān)指標(biāo)、降鈣素原(PCT)的變化;比較2組ICU住院時間以及28 d死亡率。結(jié)果:觀察組28 d死亡率為16.7%低于對照組之36.7%,但無統(tǒng)計學(xué)差異(χ~2=3.068,P=0.080);觀察組ICU住院時間為(12.25±8.32)d,明顯短于對照組(19.75±12.56)d(t=2.727,P=0.0084);觀察組第5 d、第10 dCD_(14)~+單核細(xì)胞人白細(xì)胞DR抗原(HLA-DR)、T淋巴細(xì)胞亞群(CD_4~+、CD_8~+、CD_4~+/CD_8~+)、自然殺傷細(xì)胞(NK細(xì)胞)、免疫球蛋白IgG、IgM以及PCT等指標(biāo)的的改善均優(yōu)于對照組(P0.05,P0.01)。結(jié)論:溫腎暖脾通下方能增強嚴(yán)重膿毒癥患者免疫功能,縮短患者ICU的住院時間,改善預(yù)后。
[Abstract]:Objective: to observe the clinical effect of Wenshen warming spleen Tong on severe sepsis and its regulating effect on immune paralysis. Methods: 60 patients with severe sepsis were randomly divided into two groups, 30 cases in each group. The control group was treated with routine western medicine, the observation group was treated with warm kidney and warm spleen decoction on the basis of the control group, and the APACHEII score was observed before treatment and at the 5th day and 10th day after treatment. Changes of immunological parameters, procalcitonin (PCT); Results: the mortality rate of 28 days in the observation group was 16.7% lower than that in the control group (36.7%), but there was no significant difference between the two groups (蠂 2 + 3.068). P0. 080; The hospitalization time of ICU in the observation group was 12.25 鹵8.32 days, which was significantly shorter than that in the control group (19.75 鹵12.56). In the observation group, on the 5th day and the 10th day, the number of HLA-DRN T lymphocyte subsets of monocyte Dr antigen was 14 ~ +, and CD4 ~ + + CD8 ~ + T lymphocyte subsets of human leukocyte Dr antigen were found in the observation group. The improvement of CD4 / CD8, NK cell, IgGG IgM and PCT were better than that of control group (P0.05). Conclusion: Wenshenhuanpi Tong can enhance the immune function of the patients with severe sepsis, shorten the hospitalization time of the patients with ICU, and improve the prognosis.
【作者單位】： 廣東省深圳市龍崗區(qū)中醫(yī)院;梅州市殘聯(lián)康復(fù)醫(yī)院中醫(yī)科;
【分類號】：R459.7
【正文快照】： 膿毒癥是危重癥患者死亡的首要原因,也是人類十大死亡原因之一[1],以免疫麻痹為主的免疫功能紊亂是嚴(yán)重膿毒癥患者死亡的關(guān)鍵因素[2]。增強免疫治療被國內(nèi)外學(xué)者認(rèn)為可以改善嚴(yán)重膿毒癥患者的預(yù)后,提高存活率;而一些中藥組方可以增強此類患者的免疫功能、改善預(yù)后[3]。本研究

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